

	<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN">
	<html>
	<head>
		<title>Oakdale Gun Club - Membership Entry Form</title>
		<meta http-equiv="content-type" content="text/html; charset=UTF-8"><link href="style.css" rel="stylesheet" type="text/css">
		<!-- calendar stuff -->
		      <link rel="stylesheet" type="text/css" href="calendar/calendar-blue2.css" />
		      <script type="text/javascript" src="calendar/calendar.js"></script>
		      <script type="text/javascript" src="calendar/calendar-en.js"></script>
		      <script type="text/javascript" src="calendar/calendar-setup.js"></script>
		<!-- END calendar stuff -->

	    <!-- expand/collapse function -->
	    <SCRIPT type=text/javascript>
		<!--
		function collapseElem(obj)
		{
			var el = document.getElementById(obj);
			el.style.display = 'none';
		}


		function expandElem(obj)
		{
			var el = document.getElementById(obj);
			el.style.display = '';
		}


		//-->
		</SCRIPT>
		<!-- expand/collapse function -->


		<!-- expand/collapse function -->
		    <SCRIPT type=text/javascript>
			<!--

			// collapse all elements, except the first one
			function collapseAll()
			{
				var numFormPages = 1;

				for(i=2; i <= numFormPages; i++)
				{
					currPageId = ('mainForm_' + i);
					collapseElem(currPageId);
				}
			}


			//-->
			</SCRIPT>
		<!-- expand/collapse function -->


		 <!-- validate -->
		<SCRIPT type=text/javascript>
		<!--
			function validateField(fieldId, fieldBoxId, fieldType, required)
			{
				fieldBox = document.getElementById(fieldBoxId);
				fieldObj = document.getElementById(fieldId);

				if(fieldType == 'text'  ||  fieldType == 'textarea'  ||  fieldType == 'password'  ||  fieldType == 'file'  ||  fieldType == 'phone'  || fieldType == 'website')
				{	
					if(required == 1 && fieldObj.value == '')
					{
						fieldObj.setAttribute("class","mainFormError");
						fieldObj.setAttribute("className","mainFormError");
						fieldObj.focus();
						return false;					
					}

				}


				else if(fieldType == 'menu'  || fieldType == 'country'  || fieldType == 'state')
				{	
					if(required == 1 && fieldObj.selectedIndex == 0)
					{				
						fieldObj.setAttribute("class","mainFormError");
						fieldObj.setAttribute("className","mainFormError");
						fieldObj.focus();
						return false;					
					}

				}


				else if(fieldType == 'email')
				{	
					if((required == 1 && fieldObj.value=='')  ||  (fieldObj.value!=''  && !validate_email(fieldObj.value)))
					{				
						fieldObj.setAttribute("class","mainFormError");
						fieldObj.setAttribute("className","mainFormError");
						fieldObj.focus();
						return false;					
					}

				}



			}

			function validate_email(emailStr)
			{		
				apos=emailStr.indexOf("@");
				dotpos=emailStr.lastIndexOf(".");

				if (apos<1||dotpos-apos<2) 
				{
					return false;
				}
				else
				{
					return true;
				}
			}


			function validateDate(fieldId, fieldBoxId, fieldType, required,  minDateStr, maxDateStr)
			{
				retValue = true;

				fieldBox = document.getElementById(fieldBoxId);
				fieldObj = document.getElementById(fieldId);	
				dateStr = fieldObj.value;


				if(required == 0  && dateStr == '')
				{
					return true;
				}


				if(dateStr.charAt(2) != '/'  || dateStr.charAt(5) != '/' || dateStr.length != 10)
				{
					retValue = false;
				}	

				else	// format's okay; check max, min
				{
					currDays = parseInt(dateStr.substr(0,2),10) + parseInt(dateStr.substr(3,2),10)*30  + parseInt(dateStr.substr(6,4),10)*365;
					//alert(currDays);

					if(maxDateStr != '')
					{
						maxDays = parseInt(maxDateStr.substr(0,2),10) + parseInt(maxDateStr.substr(3,2),10)*30  + parseInt(maxDateStr.substr(6,4),10)*365;
						//alert(maxDays);
						if(currDays > maxDays)
							retValue = false;
					}

					if(minDateStr != '')
					{
						minDays = parseInt(minDateStr.substr(0,2),10) + parseInt(minDateStr.substr(3,2),10)*30  + parseInt(minDateStr.substr(6,4),10)*365;
						//alert(minDays);
						if(currDays < minDays)
							retValue = false;
					}
				}

				if(retValue == false)
				{
					fieldObj.setAttribute("class","mainFormError");
					fieldObj.setAttribute("className","mainFormError");
					fieldObj.focus();
					return false;
				}
			}
		//-->
		</SCRIPT>
		<!-- end validate -->




	</head>

	<body onLoad="collapseAll()">

	<div id="mainForm">




		<div id="formHeader">
				<h2 class="formInfo">Oakdale Gun Club - Member Entry Form</h2>
				<p class="formInfo">Please enter the requested information below.</p>
		</div>


		<BR/><!-- begin form -->
		<form method=post enctype=multipart/form-data action=processor.php onSubmit="return validatePage1();"><ul class=mainForm id="mainForm_1">

				<li class="mainForm" id="fieldBox_1">
					<label class="formFieldQuestion">First Name&nbsp;*&nbsp;<a class=info href=#><img src=imgs/tip_small.png border=0><span class=infobox>Legal First Name</span></a></label><input class=mainForm type=text name=field_1 id=field_1 size='20' value=''></li>

				<li class="mainForm" id="fieldBox_2">
					<label class="formFieldQuestion">Middle Name</label><input class=mainForm type=text name=field_2 id=field_2 size='20' value=''></li>

				<li class="mainForm" id="fieldBox_3">
					<label class="formFieldQuestion">Last Name&nbsp;*</label><input class=mainForm type=text name=field_3 id=field_3 size='20' value=''></li>

				<li class="mainForm" id="fieldBox_4">
					<label class="formFieldQuestion">Preferred Name</label><input class=mainForm type=text name=field_4 id=field_4 size='20' value=''></li>

				<li class="mainForm" id="fieldBox_5">
					<label class="formFieldQuestion">Member Number&nbsp;<a class=info href=#><img src=imgs/tip_small.png border=0><span class=infobox>Found on the top of your badge.  (Near the clip hole)</span></a></label><input class=mainForm type=text name=field_5 id=field_5 size='20' value=''></li>

				<li class="mainForm" id="fieldBox_6">
					<label class="formFieldQuestion">Date of Birth&nbsp;*</label><input type=text  name=field_6 id=field_6 value=""><button type=reset class=calendarStyle id=fieldDateTrigger_6></button><SCRIPT type='text/javascript'>   Calendar.setup({
								inputField     :    "field_6",   
								ifFormat       :    "%m/%d/%Y",   
								showsTime      :    false,          
								button         :    "fieldDateTrigger_6",
								singleClick    :    true,           
								step           :    1                
								});</SCRIPT></li>

				<li class="mainForm" id="fieldBox_7">
					<label class="formFieldQuestion">Sex&nbsp;*</label><span><input class=mainForm type=radio name=field_7 id=field_7_option_1 value="Male" /><label class=formFieldOption for="field_7_option_1">Male</label><input class=mainForm type=radio name=field_7 id=field_7_option_2 value="Female" /><label class=formFieldOption for="field_7_option_2">Female</label></span></li>

				<li class="mainForm" id="fieldBox_8">
					<label class="formFieldQuestion">Address&nbsp;*</label><input class=mainForm type=text name=field_8 id=field_8 size='20' value=''></li>

				<li class="mainForm" id="fieldBox_9">
					<label class="formFieldQuestion">Address 2</label><input class=mainForm type=text name=field_9 id=field_9 size='20' value=''></li>

				<li class="mainForm" id="fieldBox_10">
					<label class="formFieldQuestion">City&nbsp;*</label><input class=mainForm type=text name=field_10 id=field_10 size='20' value=''></li>

				<li class="mainForm" id="fieldBox_11">
					<label class="formFieldQuestion">State&nbsp;*</label><select class=mainForm name=field_11 id=field_11><option value=''> </option><option value="Alabama">Alabama</option><option value="Alaska">Alaska</option><option value="Arizona">Arizona</option><option value="Arkansas">Arkansas</option><option value="California">California</option><option value="Colorado">Colorado</option><option value="Connecticut">Connecticut</option><option value="Delaware">Delaware</option><option value="Florida">Florida</option><option value="Georgia">Georgia</option><option value="Hawaii">Hawaii</option><option value="Idaho">Idaho</option><option value="Illinois">Illinois</option><option value="Indiana">Indiana</option><option value="Iowa">Iowa</option><option value="Kansas">Kansas</option><option value="Kentucky">Kentucky</option><option value="Louisiana">Louisiana</option><option value="Maine">Maine</option><option value="Maryland">Maryland</option><option value="Massachusetts">Massachusetts</option><option value="Michigan">Michigan</option><option value="Minnesota">Minnesota</option><option value="Mississippi">Mississippi</option><option value="Missouri">Missouri</option><option value="Montana">Montana</option><option value="Nebraska">Nebraska</option><option value="Nevada">Nevada</option><option value="New Hampshire">New Hampshire</option><option value="New Jersey">New Jersey</option><option value="New Mexico">New Mexico</option><option value="New York">New York</option><option value="North Carolina">North Carolina</option><option value="North Dakota">North Dakota</option><option value="Ohio">Ohio</option><option value="Oklahoma">Oklahoma</option><option value="Oregon">Oregon</option><option value="Pennsylvania">Pennsylvania</option><option value="Rhode Island">Rhode Island</option><option value="South Carolina">South Carolina</option><option value="South Dakota">South Dakota</option><option value="Tennessee">Tennessee</option><option value="Texas">Texas</option><option value="Utah">Utah</option><option value="Vermont">Vermont</option><option value="Virginia">Virginia</option><option value="Washington">Washington</option><option value="West Virginia">West Virginia</option><option value="Wisconsin">Wisconsin</option><option value="Wyoming">Wyoming</option></SELECT></li>

				<li class="mainForm" id="fieldBox_12">
					<label class="formFieldQuestion">Post Code&nbsp;*</label><input class=mainForm type=text name=field_12 id=field_12 size='20' value=''></li>

				<li class="mainForm" id="fieldBox_13">
					<label class="formFieldQuestion">Country&nbsp;*</label><select class=mainForm name=field_13 id=field_13><option value=''> </option><option value="Abkhazia">Abkhazia</option><option value="Afghanistan">Afghanistan</option><option value="Aland">Aland</option><option value="Albania">Albania</option><option value="Algeria">Algeria</option><option value="American Samoa">American Samoa</option><option value="Andorra">Andorra</option><option value="Angola">Angola</option><option value="Anguilla">Anguilla</option><option value="Antarctica">Antarctica</option><option value="Antigua and Barbuda">Antigua and Barbuda</option><option value="Argentina">Argentina</option><option value="Armenia">Armenia</option><option value="Aruba">Aruba</option><option value="Ascension">Ascension</option><option value="Ashmore and Cartier Islands">Ashmore and Cartier Islands</option><option value="Australia">Australia</option><option value="Australian Antarctic Territory">Australian Antarctic Territory</option><option value="Austria">Austria</option><option value="Azerbaijan">Azerbaijan</option><option value="Bahamas, The">Bahamas, The</option><option value="Bahrain">Bahrain</option><option value="Baker Island">Baker Island</option><option value="Bangladesh">Bangladesh</option><option value="Barbados">Barbados</option><option value="Belarus">Belarus</option><option value="Belgium">Belgium</option><option value="Belize">Belize</option><option value="Benin">Benin</option><option value="Bermuda">Bermuda</option><option value="Bhutan">Bhutan</option><option value="Bolivia">Bolivia</option><option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option><option value="Botswana">Botswana</option><option value="Bouvet Island">Bouvet Island</option><option value="Brazil">Brazil</option><option value="British Antarctic Territory">British Antarctic Territory</option><option value="British Indian Ocean Territory">British Indian Ocean Territory</option><option value="British Sovereign Base Areas">British Sovereign Base Areas</option><option value="British Virgin Islands">British Virgin Islands</option><option value="Brunei">Brunei</option><option value="Bulgaria">Bulgaria</option><option value="Burkina Faso">Burkina Faso</option><option value="Burundi">Burundi</option><option value="Cambodia">Cambodia</option><option value="Cameroon">Cameroon</option><option value="Canada">Canada</option><option value="Cape Verde">Cape Verde</option><option value="Cayman Islands">Cayman Islands</option><option value="Central African Republic">Central African Republic</option><option value="Chad">Chad</option><option value="Chile">Chile</option><option value="China, People's Republic of">China, People's Republic of</option><option value="China, Republic of (Taiwan)">China, Republic of (Taiwan)</option><option value="Christmas Island">Christmas Island</option><option value="Clipperton Island">Clipperton Island</option><option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option><option value="Colombia">Colombia</option><option value="Comoros">Comoros</option><option value="Congo, Democratic Republic of the (Congo  Kinshasa)">Congo, Democratic Republic of the (Congo  Kinshasa)</option><option value="Congo, Republic of the (Congo  Brazzaville)">Congo, Republic of the (Congo  Brazzaville)</option><option value="Cook Islands">Cook Islands</option><option value="Coral Sea Islands">Coral Sea Islands</option><option value="Costa Rica">Costa Rica</option><option value="Cote d'Ivoire (Ivory Coast)">Cote d'Ivoire (Ivory Coast)</option><option value="Croatia">Croatia</option><option value="Cuba">Cuba</option><option value="Cyprus">Cyprus</option><option value="Czech Republic">Czech Republic</option><option value="Denmark">Denmark</option><option value="Djibouti">Djibouti</option><option value="Dominica">Dominica</option><option value="Dominican Republic">Dominican Republic</option><option value="Ecuador">Ecuador</option><option value="Egypt">Egypt</option><option value="El Salvador">El Salvador</option><option value="Equatorial Guinea">Equatorial Guinea</option><option value="Eritrea">Eritrea</option><option value="Estonia">Estonia</option><option value="Ethiopia">Ethiopia</option><option value="Falkland Islands (Islas Malvinas)">Falkland Islands (Islas Malvinas)</option><option value="Faroe Islands">Faroe Islands</option><option value="Fiji">Fiji</option><option value="Finland">Finland</option><option value="France">France</option><option value="French Guiana">French Guiana</option><option value="French Polynesia">French Polynesia</option><option value="French Scattered Islands in the Indian Ocean">French Scattered Islands in the Indian Ocean</option><option value="French Southern and Antarctic Lands">French Southern and Antarctic Lands</option><option value="Gabon">Gabon</option><option value="Gambia, The">Gambia, The</option><option value="Georgia">Georgia</option><option value="Germany">Germany</option><option value="Ghana">Ghana</option><option value="Gibraltar">Gibraltar</option><option value="Greece">Greece</option><option value="Greenland">Greenland</option><option value="Grenada">Grenada</option><option value="Guadeloupe">Guadeloupe</option><option value="Guam">Guam</option><option value="Guatemala">Guatemala</option><option value="Guernsey">Guernsey</option><option value="Guinea">Guinea</option><option value="Guinea-Bissau">Guinea-Bissau</option><option value="Guyana">Guyana</option><option value="Haiti">Haiti</option><option value="Heard Island and McDonald Islands">Heard Island and McDonald Islands</option><option value="Honduras">Honduras</option><option value="Hong Kong">Hong Kong</option><option value="Howland Island">Howland Island</option><option value="Hungary">Hungary</option><option value="Iceland">Iceland</option><option value="India">India</option><option value="Indonesia">Indonesia</option><option value="Iran">Iran</option><option value="Iraq">Iraq</option><option value="Ireland">Ireland</option><option value="Isle of Man">Isle of Man</option><option value="Israel">Israel</option><option value="Italy">Italy</option><option value="Jamaica">Jamaica</option><option value="Japan">Japan</option><option value="Jarvis Island">Jarvis Island</option><option value="Jersey">Jersey</option><option value="Johnston Atoll">Johnston Atoll</option><option value="Jordan">Jordan</option><option value="Kazakhstan">Kazakhstan</option><option value="Kenya">Kenya</option><option value="Kingman Reef">Kingman Reef</option><option value="Kiribati">Kiribati</option><option value="Korea, Democratic People's Republic of (North Korea)">Korea, Democratic People's Republic of (North Korea)</option><option value="Korea, Republic of  (South Korea)">Korea, Republic of  (South Korea)</option><option value="Kosovo">Kosovo</option><option value="Kuwait">Kuwait</option><option value="Kyrgyzstan">Kyrgyzstan</option><option value="Laos">Laos</option><option value="Latvia">Latvia</option><option value="Lebanon">Lebanon</option><option value="Lesotho">Lesotho</option><option value="Liberia">Liberia</option><option value="Libya">Libya</option><option value="Liechtenstein">Liechtenstein</option><option value="Lithuania">Lithuania</option><option value="Luxembourg">Luxembourg</option><option value="Macau">Macau</option><option value="Macedonia">Macedonia</option><option value="Madagascar">Madagascar</option><option value="Malawi">Malawi</option><option value="Malaysia">Malaysia</option><option value="Maldives">Maldives</option><option value="Mali">Mali</option><option value="Malta">Malta</option><option value="Marshall Islands">Marshall Islands</option><option value="Martinique">Martinique</option><option value="Mauritania">Mauritania</option><option value="Mauritius">Mauritius</option><option value="Mayotte">Mayotte</option><option value="Mexico">Mexico</option><option value="Micronesia">Micronesia</option><option value="Midway Islands">Midway Islands</option><option value="Moldova">Moldova</option><option value="Monaco">Monaco</option><option value="Mongolia">Mongolia</option><option value="Montenegro">Montenegro</option><option value="Montserrat">Montserrat</option><option value="Morocco">Morocco</option><option value="Mozambique">Mozambique</option><option value="Myanmar (Burma)">Myanmar (Burma)</option><option value="Nagorno-Karabakh">Nagorno-Karabakh</option><option value="Namibia">Namibia</option><option value="Nauru">Nauru</option><option value="Navassa Island">Navassa Island</option><option value="Nepal">Nepal</option><option value="Netherlands">Netherlands</option><option value="Netherlands Antilles">Netherlands Antilles</option><option value="New Caledonia">New Caledonia</option><option value="New Zealand">New Zealand</option><option value="Nicaragua">Nicaragua</option><option value="Niger">Niger</option><option value="Nigeria">Nigeria</option><option value="Niue">Niue</option><option value="Norfolk Island">Norfolk Island</option><option value="Northern Cyprus">Northern Cyprus</option><option value="Northern Mariana Islands">Northern Mariana Islands</option><option value="Norway">Norway</option><option value="Oman">Oman</option><option value="Pakistan">Pakistan</option><option value="Palau">Palau</option><option value="Palestine">Palestine</option><option value="Palmyra Atoll">Palmyra Atoll</option><option value="Panama">Panama</option><option value="Papua New Guinea">Papua New Guinea</option><option value="Paraguay">Paraguay</option><option value="Peru">Peru</option><option value="Peter I Island">Peter I Island</option><option value="Philippines">Philippines</option><option value="Pitcairn Islands">Pitcairn Islands</option><option value="Poland">Poland</option><option value="Portugal">Portugal</option><option value="Pridnestrovie (Transnistria)">Pridnestrovie (Transnistria)</option><option value="Puerto Rico">Puerto Rico</option><option value="Qatar">Qatar</option><option value="Queen Maud Land">Queen Maud Land</option><option value="Reunion">Reunion</option><option value="Romania">Romania</option><option value="Ross Dependency">Ross Dependency</option><option value="Russia">Russia</option><option value="Rwanda">Rwanda</option><option value="Saint Helena">Saint Helena</option><option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option><option value="Saint Lucia">Saint Lucia</option><option value="Saint Pierre and Miquelon">Saint Pierre and Miquelon</option><option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option><option value="Samoa">Samoa</option><option value="San Marino">San Marino</option><option value="Sao Tome and Principe">Sao Tome and Principe</option><option value="Saudi Arabia">Saudi Arabia</option><option value="Senegal">Senegal</option><option value="Serbia">Serbia</option><option value="Seychelles">Seychelles</option><option value="Sierra Leone">Sierra Leone</option><option value="Singapore">Singapore</option><option value="Slovakia">Slovakia</option><option value="Slovenia">Slovenia</option><option value="Solomon Islands">Solomon Islands</option><option value="Somalia">Somalia</option><option value="Somaliland">Somaliland</option><option value="South Africa">South Africa</option><option value="South Georgia and the South Sandwich Islands">South Georgia and the South Sandwich Islands</option><option value="South Ossetia">South Ossetia</option><option value="Spain">Spain</option><option value="Sri Lanka">Sri Lanka</option><option value="Sudan">Sudan</option><option value="Suriname">Suriname</option><option value="Svalbard">Svalbard</option><option value="Swaziland">Swaziland</option><option value="Sweden">Sweden</option><option value="Switzerland">Switzerland</option><option value="Syria">Syria</option><option value="Tajikistan">Tajikistan</option><option value="Tanzania">Tanzania</option><option value="Thailand">Thailand</option><option value="Timor-Leste (East Timor)">Timor-Leste (East Timor)</option><option value="Togo">Togo</option><option value="Tokelau">Tokelau</option><option value="Tonga">Tonga</option><option value="Trinidad and Tobago">Trinidad and Tobago</option><option value="Tristan da Cunha">Tristan da Cunha</option><option value="Tunisia">Tunisia</option><option value="Turkey">Turkey</option><option value="Turkmenistan">Turkmenistan</option><option value="Turks and Caicos Islands">Turks and Caicos Islands</option><option value="Tuvalu">Tuvalu</option><option value="U.S. Virgin Islands">U.S. Virgin Islands</option><option value="Uganda">Uganda</option><option value="Ukraine">Ukraine</option><option value="United Arab Emirates">United Arab Emirates</option><option value="United Kingdom">United Kingdom</option><option value="United States">United States</option><option value="Uruguay">Uruguay</option><option value="Uzbekistan">Uzbekistan</option><option value="Vanuatu">Vanuatu</option><option value="Vatican City">Vatican City</option><option value="Venezuela">Venezuela</option><option value="Viet Nam">Viet Nam</option><option value="Wake Island">Wake Island</option><option value="Wallis and Futuna">Wallis and Futuna</option><option value="Western Sahara">Western Sahara</option><option value="Yemen">Yemen</option><option value="Zambia">Zambia</option><option value="Zimbabwe">Zimbabwe</option></SELECT></li>

				<li class="mainForm" id="fieldBox_14">
					<label class="formFieldQuestion">Email&nbsp;*</label><input class=mainForm type=email name=field_14 id=field_14 size=20 value="" style="background-image:url(imgs/email.png); background-repeat: no-repeat;  padding: 2px 2px 2px 25px;"></li>

				<li class="mainForm" id="fieldBox_15">
					<label class="formFieldQuestion">Home Phone</label><input class=mainForm type=phone name=field_15 id=field_15 size=20 value="" style="background-image:url(imgs/phone.png); background-repeat: no-repeat;  padding: 2px 2px 2px 25px;"></li>

				<li class="mainForm" id="fieldBox_16">
					<label class="formFieldQuestion">Mobile Phone</label><input class=mainForm type=phone name=field_16 id=field_16 size=20 value="" style="background-image:url(imgs/phone.png); background-repeat: no-repeat;  padding: 2px 2px 2px 25px;"></li>

				<li class="mainForm" id="fieldBox_17">
					<label class="formFieldQuestion">NRA Number&nbsp;*</label><input class=mainForm type=text name=field_17 id=field_17 size='20' value=''></li>

				<li class="mainForm" id="fieldBox_18">
					<label class="formFieldQuestion">NRA Experation&nbsp;*&nbsp;<a class=info href=#><img src=imgs/tip_small.png border=0><span class=infobox>Life Members Choose 12/31/9999</span></a></label><input type=text  name=field_18 id=field_18 value=""><button type=reset class=calendarStyle id=fieldDateTrigger_18></button><SCRIPT type='text/javascript'>   Calendar.setup({
								inputField     :    "field_18",   
								ifFormat       :    "%m/%d/%Y",   
								showsTime      :    false,          
								button         :    "fieldDateTrigger_18",
								singleClick    :    true,           
								step           :    1                
								});</SCRIPT></li>
		
		
		<!-- end of this page -->

		<!-- page validation -->
		<SCRIPT type=text/javascript>
		<!--
			function validatePage1()
			{
				retVal = true;
				if (validateField('field_1','fieldBox_1','text',1) == false)
 retVal=false;
if (validateField('field_3','fieldBox_3','text',1) == false)
 retVal=false;
if (validateField('field_4','fieldBox_4','text',0) == false)
 retVal=false;
if (validateField('field_5','fieldBox_5','text',0) == false)
 retVal=false;
if (validateDate('field_6','fieldBox_6','date',1,'','') == false)
 retVal=false;
if (validateField('field_7','fieldBox_7','radio',1) == false)
 retVal=false;
if (validateField('field_8','fieldBox_8','text',1) == false)
 retVal=false;
if (validateField('field_9','fieldBox_9','text',0) == false)
 retVal=false;
if (validateField('field_10','fieldBox_10','text',1) == false)
 retVal=false;
if (validateField('field_11','fieldBox_11','state',1) == false)
 retVal=false;
if (validateField('field_12','fieldBox_12','text',1) == false)
 retVal=false;
if (validateField('field_13','fieldBox_13','country',1) == false)
 retVal=false;
if (validateField('field_14','fieldBox_14','email',1) == false)
 retVal=false;
if (validateField('field_15','fieldBox_15','phone',0) == false)
 retVal=false;
if (validateField('field_16','fieldBox_16','phone',0) == false)
 retVal=false;
if (validateField('field_17','fieldBox_17','text',1) == false)
 retVal=false;
if (validateDate('field_18','fieldBox_18','date',1,'','') == false)
 retVal=false;

				if(retVal == false)
				{
					alert('Please correct the errors.  Fields marked with an asterisk (*) are required');
					return false;
				}
				return retVal;
			}
		//-->
		</SCRIPT>

		<!-- end page validaton -->



		<!-- next page buttons --><li class="mainForm">
					<input id="saveForm" class="mainForm" type="submit" value="Submit" />
				</li>

			</form>
			<!-- end of form -->
		<!-- est close the display stuff for this page -->
		</ul></div><div id="footer"></div>

	</body>
	</html>
